Medicaid program is still broken

| September 30, 2014

medicaidEditorial published in the Jacksonville Daily News, September 29, 2014.

North Carolina taxpayers have spent more than $7.2 million on consultants for the department that administers Medicaid and other human services programs since Gov. Pat McCrory took office. Much of that money has been in the form of a no-bid contract for one firm. There is reason to question whether the taxpayers are getting their money’s worth, and whether they could do better.

Turnover and ongoing problems involving cost, accountability for payments to private providers and general bureaucracy have exacerbated problems that existed well before McCrory took office. Aldona Wos, who runs the Department of Health and Human Services, said the situation was an “emergency” that required going around the bidding process.

The state’s $13 billion Medicaid program has long been problematic because of the costs involved, the complexity of administering it and the compartmentalization of the programs. Even efforts to address the latter through a one-stop application system for Medicaid, food stamps and other public assistance programs have faced huge stumbling blocks. Officials are still grappling with the effects of NC FAST, which resulted in severe delays in getting food stamps and other services to needy residents. And lawmakers are growing frustrated with delays in getting answers to basic questions, such as how many people are receiving services in each program.

In addition, the state’s refusal to accept federal funding in exchange for expanding the program to cover more low-income residents is costing the state. Budget researchers estimate that the state will give up more than half a billion dollars this year and up to $2.5 billion annually over the next several years. A McClatchy newspapers analysis estimated that North Carolina taxpayers will be subsidizing Medicaid recipients in other states to the tune of $10 million a year.

Whatever the case, DHHS, under Wos, has determined that no one in the department is capable of handling financial oversight, so she has handed that duty over to a group of consultants whose top executives charge $473 an hour for their services. One of the principals, Rudy Dimmling, has assumed the de facto role as chief financial officer. Based on his rate, he’s being paid the equivalent of $800,000 a year; a state employee with his qualifications would earn about $185,000. The firm’s contract was expanded recently from $3.2 million to $6.8 million, with no bid.

Wos has been in her position for more than a year and a half, and has been the subject of considerable criticism. Nevertheless, McCrory praises her knowledge and management skills. Surely, then, she could find someone with the skills to fill the position on a full-time basis, at a fraction of the cost of paying a consultant.

Consultants have their place, and expert advice can help overworked employees zero in on solutions that can be difficult to find from up close. But state officials have an obligation to spend money wisely, and $7.2 million can buy quite a few qualified, well-compensated employees who are accountable to the taxpayers.

http://www.jdnews.com/opinion/our-opinion/medicaid-program-is-still-broken-1.379945?page=0

Category: SPIN Blog

Comments (1)

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  1. Richard Bunce says:

    Not expanding the program has nothing to do with running the existing program… and of course government bureaucrats are incompetent.